Searchable abstracts of presentations at key conferences in endocrinology

ea0025p19 | Bone | SFEBES2011

Cervical cord compression in a patient with Paget's disease and primary hyperparathyroidism: a diagnostic challenge

Ho Jan Hoong , Dixit Kashinath , Golash Aprajay , Howell Simon

Case: A 77-year-old man was admitted with a pathological fracture of the right femur, which required intramedullary nailing. He had previously been diagnosed with Paget’s disease affecting the right femur and also hyperparathyroidism with a large parathyroid adenoma on Sestamibi scan which had been managed at another hospital. On this admission, his corrected calcium was 2.79 (2.15–2.55) mmol/l, PTH 643 (15–65) pg/ml and alkaline phosphatase 258 (30–130) U/...

ea0077op6.4 | Endocrine Cancer and Late Effects | SFEBES2021

Virtual Blood Pressure Monitoring in the Pre-operative Management of Phaeochromocytoma Patients in a Tertiary Centre during the COVID-19 Pandemic

Mile Rebecca , Bi Yixi , Gulamhusein Aziz , Hoong Ho Jan , Adam Safwaan

The usual management at our centre for patients awaiting phaeochromocytoma surgery involves pre-operative titration of alpha blockade with frequent clinic visits for blood pressure (BP) and heart rate (HR) monitoring. The COVID-19 pandemic restricted our ability to consult with patients frequently. To reduce infection risk, we incorporated virtual BP monitoring using a Microsoft Excel template coupled with regular remote consultations. We present a clinical case highlighting o...

ea0038p64 | Clinical practice/governance and case reports | SFEBES2015

Resistant hypocalcaemia secondary to denosumab: two case reports

Clay Caroline , Ho Jan Hoong , Severn Maia , Kaushal Kalpana , Howell Simon

Case 1: A 65-year-old man was admitted with symptomatic hypocalcaemia (corrected calcium of 1.65 mmol/l, PTH 46.6 (1.6–6.8) pmol/l, and vitamin D 51.4 (50–150) nmol/l)) 5 days following denosumab initiation. He had a diagnosis of probable urothelial carcinoma with associated osteoblastic metastases, and 10 days prior to this admission had been treated for hypercalcaemia (corrected calcium of 3.04 (2.20–2.60) mmol/l) with i.v. fluids following which denosumab was...

ea0038p342 | Pituitary | SFEBES2015

TSH-secreting pituitary adenoma with negative TSH staining

Khan Amber , Leow Khai , Ho Jan Hoong , Kaushal Kalpana , Howell Simon

A 31-year-old woman presented with oligomenorrhoea and a raised prolactin. Pituitary scan revealed a 1.8 cm pituitary mass with compression of the optic chiasm. TSH was normal at 3.66 mIU/l with a raised FT4 of 25.8 pmol/l. The rest of pituitary function was normal. Visual fields demonstrated a bitemporal upper quadrantanopia. A diagnosis of TSH-secreting pituitary adenoma was suspected because of the high normal TSH in the presence of a high FT4. She und...

ea0038p423 | Steroids | SFEBES2015

Transient adrenal insufficiency following acute bilateral adrenal haemorrhage

Ho Jan Hoong , Leow Khai , Khan Amber , Howell Simon , Kaushal Kalpana

: A 61-year-old gentleman was referred to the Endocrine team with acute bilateral adrenal haemorrhage. He had undergone a successful left popliteal embolectomy for critical limb ischaemia a week ago following which he was commenced on anticoagulation therapy. He presented to the Emergency Department with acute severe abdominal pain and low grade pyrexia of 37.6 C. He was haemodynamically stable. His International Normalised Ratio was noted to be elevated at 4.7. An urgent abdo...

ea0028p368 | Thyroid | SFEBES2012

An audit on the management of hypothyroidism in pregnancy

Ho Jan Hoong , Dixit Kashinath , Abdo Khalil , Howell Simon , Kaushal Kalpana

Introduction: Maternal hypothyroidism is associated with an increased risk of complications both to the pregnant mother and the developing fetus. The 2007 American Endocrine Society Guidelines recommend a rapid titration of thyroxine dose to attain a target TSH concentration of ≤2.5 µU/mL in the 1st trimester (≤3 µU/mL in the 2nd and 3rd trimesters). Objectives Our aims were to assess the adequacy of thyroxine replacement in pregnant women with hypothyroi...

ea0094p302 | Endocrine Cancer and Late Effects | SFEBES2023

Thyroid function in patients receiving immune checkpoint inhibitors: a large real-world cohort study

Kennedy Oliver , Hoong Ho Jan , Monaghan Phillip , Lorigan Paul , Adam Safwaan

Objective: This study aimed to characterise the relationship between immune checkpoint inhibitors (ICIs), which are commonly used to treat cancer, and thyroid dysfunction in terms of the proportions affected, timing of onset, sequalae and risk factors.Design: Retrospective cohort studyMethods: Patients with normal baseline thyroid function who received an ICI were included. Proport...

ea0094p93 | Neuroendocrinology and Pituitary | SFEBES2023

The clinical course of pituitary metastases: illustrations from clinical cases

Shaikh Sheeba , Iqbal Zohaib , Garcez kate , Waddell Tom , Hoong Ho Jan , Adam Safwaan

Pituitary metastases are reportedly uncommon. Here we report two cases illustrating metastases responding to systemic anticancer therapy (SACT). A 49-year-old woman with metastatic renal cell carcinoma treated with combination ipilimumab and nivolumab immunotherapy was referred for hypocortisolaemia (morning cortisol 74 nmol/l). Biochemical screening revealed an adrenocorticotropic hormone of 16ng/l (0-46), thyroid-stimulating-hormone 0.1mU/l (0.55-4.78), free thyroxine 7 pmol...

ea0077p224 | Neuroendocrinology and Pituitary | SFEBES2021

Three cases of metastatic spinal cord compression secondary to malignant pheochromocytoma and paraganglioma

Khan Amber , Kapoor Ashutosh , Manoharan Prakash , Chander Amarjot , Westwood Thomas , Woolf David , Hoong Ho Jan , Adam Safwaan

Approximately 15-20% of phaeochromocytomas and paragangliomas (PPGL) are metastatic. Metastatic spinal cord compression (MSCC) has been reported infrequently. We present three cases of MSCC secondary to metastatic PPGLs. MSCC can occur in patients with PPGLs and should be considered in patients with either spinal symptoms or spinal metastases on imaging. Our series has shown radiotherapy followed by therapeutic MIBG to be effective in treating spinal metastases. Each case shou...

ea0090p666 | Endocrine-related Cancer | ECE2023

A rare case of immunotherapy related adrenalitis

Ganawa Shawg , Mashamba Chiedza , Ilyas Waqas , Higham Claire , Cooksley Tim , Hoong Ho Jan , Adam Safwaan , Dhage Shaishav

Introduction: Immunotherapy has transformed the outcomes of various cancers. Monoclonal antibodies against cytotoxic T lymphocyte antigen 4 (CTLA4), programmed cell death 1 (PD1) and its ligand, PDL1 target mainly T cells, unleashing the immune system against tumour cells. Immune checkpoint inhibitor therapy results in a variety of immune related adverse events, including various endocrinopathies. Thyroid disorders, pituitary disorders are relatively more common compared to pr...